![[dr. bob]](/dr-bob-sm.gif)
Dr. Bob is Robert Hsiung, MD,
[email protected]Shown: posts 12 to 36 of 37. Go back in thread:
Posted by babs on July 12, 2003, at 9:48:59
In reply to risperdal for anxiety, posted by jenna23 on June 12, 2002, at 18:46:31
Risperdal (2.0 mg) worked relly well for my anxiety and OCD as an augmentation to celexa. It was the calmest I've felt in years but it gave me two major p[roblems- I gained 60 pounds and I had a great deal of difficulty concentrating and had to add adderalll. But despite those problems, I still think it is an amazing drug. Every drug affects people differently so you may not gain any weight at all. I think my case was extreme. I have since switched to klonopin ( had to stop risperdal because my prolactin levels were too elevated) and that seems to be working well. I was sad when I had to stop[ the risperdal though. Best, babs
Posted by taister on December 26, 2003, at 3:16:37
In reply to risperdal for anxiety, posted by jenna23 on June 12, 2002, at 18:46:31
I take 3mg/day of Risperdal. Thoughts gone. I feel like a mindless zombie too. No creativity or now after 2 weeks.. a different creativity. Anxiety has increased tenfold. Level of Prolactin I guess is much higher than usual because I do not ejaculate normally.
To fight the intense anxiety I take Ativan 0.5 to 1mg whenever I can't cope with anxiety anymore.
Posted by leopard on December 28, 2003, at 2:25:15
In reply to Re: risperdal for anxiety, posted by taister on December 26, 2003, at 3:16:37
> I take 3mg/day of Risperdal. Thoughts gone. I feel like a mindless zombie too. No creativity or now after 2 weeks.. a different creativity. Anxiety has increased tenfold. Level of Prolactin I guess is much higher than usual because I do not ejaculate normally.
>
> To fight the intense anxiety I take Ativan 0.5 to 1mg whenever I can't cope with anxiety anymore.
Has anyone on this thread tried Geodon? It is supposed to be like Risperdal but with NO weight gain. I am relatively new to this board, but I have noticed that there isn't a whole lot being said about Geodon. I am BPII and Geodon seems to be a miracle...just wanted to share this...
Posted by KathrynLex on December 30, 2003, at 12:43:39
In reply to Re: risperdal for anxiety, posted by leopard on December 28, 2003, at 2:25:15
My pdoc initially prescribed risperdal and lexapro for my anxiety. I've heard that this has been a very successful combination for many people. (I didn't care for it though.)
Posted by JLM on December 31, 2003, at 20:28:42
In reply to Re: risperdal for anxiety, posted by leopard on December 28, 2003, at 2:25:15
Are there any gold label studies that shows Risperidone is effective for anxiety, or ANY studies at ALL for that matter?
Here's a nice little ditty about Risperidone, and off label prescribing:
"Victims of off-label prescribing whom Knight Ridder interviewed have suffered heart attacks and strokes, had permanent nerve damage or lost their eyesight. Most said they never were told that the FDA hadn't approved their treatments.
Based on the FDA's own data, Knight Ridder estimates that at least 8,000 people became seriously ill last year after taking some of the nation's most popular drugs off-label. The true number is likely to be many times higher.
"Sometimes it may help, sometimes it may do more harm than good and sometimes it may kill people," said Arnold Relman, a former editor of the prestigious New England Journal of Medicine.
Despite the rise in off-label drug use, the FDA has done little to discourage it, and is considering whether to allow drug companies greater leeway in pushing unapproved therapies.
George Murphy's hands, made strong by years of climbing utility poles for Houston Lighting & Power, shake with tremors. His legs, now rigid, shuffle as he pushes his walker through his studio apartment in Deer Park, Texas.
"I wish I didn't have to use this thing," he said as the walker snagged on his recliner while he was showing off his Army dog tags from World War II, a plaque for 40 years of service as a Mason, his Shriner fez and the oil paintings his wife did a few years before she died.
Murphy, now 85, began having the tremors last year after he had a series of strokelike attacks while taking Risperdal, a powerful antipsychotic drug that the FDA has approved only for treating schizophrenia.
Murphy's family practitioner in Pasadena, Texas, Dr. Dennis Yaworski, prescribed Risperdal for an off-label purpose: "cancer phobia," according to case notes from an office visit on Sept. 9, 2002.
The drug's maker, Johnson & Johnson, has marketed Risperdal heavily to doctors who treat elderly patients.
In 1999 the FDA cited Johnson & Johnson for downplaying the drug's risks to the elderly and making false and misleading claims that it could be used not just to treat schizophrenia, but also "for psychotic symptoms associated with a broad range of disorders."
While doctors are free to prescribe as they wish, the FDA prohibits drug-makers from marketing unapproved treatments.
Despite the FDA's action, Risperdal has become a popular off-label treatment for Alzheimer's disease and dementia. About 670,000 such prescriptions were written last year, up more than 350 percent from 1998, the Knight Ridder analysis found. Sixty-five percent of Risperdal's prescriptions last year were for unapproved treatments, generating $929 million in retail sales.
Then in April 2003, Johnson & Johnson sent a letter to U.S. doctors warning that Risperdal may be associated with an increase in strokes when prescribed off-label to elderly dementia patients.
The public warning came nearly two years after the drug maker privately alerted the FDA that there was a problem with Risperdal, agency officials said in response to questions from Knight Ridder. It came six months after drug regulators in Canada issued a similar warning and urged doctors in that country to reassess their use of Risperdal to treat dementia.
FDA officials, in a written statement, said it took several rounds of questions to the drug maker before they had enough evidence to have the drug company issue the warning. Johnson & Johnson, based in New Brunswick, N.J., had no comment.
Murphy and his family have sued the drug company, which in court filings denies any wrongdoing. His daughter, Robbie Murphy, said: "Our father has been taken away from us. Basically the last enjoyable times he could have with us are gone."
Cancer PHOBIA? I'd read the whole article folks.
Posted by Utopia on January 1, 2004, at 16:55:31
In reply to Re: risperdal for anxiety, posted by JLM on December 31, 2003, at 20:28:42
Hi
For years I took Risperdal to help my sleeping. Not for schizophrenia but to assist my sleep and anxiety including panic attacks.
I took a minute dose. It worked like a charm. As far as I could tell there were no side effects and I slept like a baby.
Then it started, a very slight twitching in my left leg that eventually would be noticeable if I was lying down on the couch with the leg semi-bent.
It had not got to the point that I couldn't walk but ...man oh man was it irritating! Went to see the pdoc, took me of it and replaced it with something else. The twitch took three months to completely dissapear, I'm lucky I suppose because once there I believe it can stay, even if off the medicines-incredible!
So if you're twitching down under and you're on Risperdal, see your doctor.
Posted by JacquieJ on January 2, 2004, at 8:10:40
In reply to Re: risperdal for anxiety, posted by JLM on December 31, 2003, at 20:28:42
Risperdal can help some people with anxiety. And as far as off label uses, that is how MANY drugs get discovered for so many new uses (THANK GOD). My nephew had major problems with PTSD as well as anxiety after he came back from the Gulf War. The PC doc tried all kinds of antidepressant cocktails including xanax (highly addictive!) and none helped. He went to a Psych at the VA who fully informed him of what Risperdal's potential side effects were (weight gain, decreased libido, etc) but Stuart was willing to try ANYTHING short of suicide (which he had thoughts of). Risperdal added onto lexapro was the magic bullet. He has been on 1mg Risp and lexapro (celexa first and then switched) and he is a new person. I think we all need to be a little less accusing of drug companies these days...I agree that there are certainly abuses that take place-but I wouldn't want to go anywhere else in the WORLD for my health care. There is no "one drug fits all" in this world. I volunteer for NAMI and have seen time and time again patients who don't work on one agent and then are switched to another with great results. The brain is a mysterious thing and it is an art form to help heal it. Off label uses of drugs are miracles for many, so respectfully, I suggest unnecessarily alarming people into thinking their docs are intentionally harming them.
Posted by JLM on January 2, 2004, at 8:48:14
In reply to Re: risperdal for anxiety, posted by JacquieJ on January 2, 2004, at 8:10:40
> Risperdal can help some people with anxiety. And as far as off label uses, that is how MANY drugs get discovered for so many new uses (THANK GOD). My nephew had major problems with PTSD as well as anxiety after he came back from the Gulf War. The PC doc tried all kinds of antidepressant cocktails including xanax (highly addictive!) and none helped. He went to a Psych at the VA who fully informed him of what Risperdal's potential side effects were (weight gain, decreased libido, etc) but Stuart was willing to try ANYTHING short of suicide (which he had thoughts of). Risperdal added onto lexapro was the magic bullet. He has been on 1mg Risp and lexapro (celexa first and then switched) and he is a new person. I think we all need to be a little less accusing of drug companies these days...I agree that there are certainly abuses that take place-but I wouldn't want to go anywhere else in the WORLD for my health care. There is no "one drug fits all" in this world. I volunteer for NAMI and have seen time and time again patients who don't work on one agent and then are switched to another with great results. The brain is a mysterious thing and it is an art form to help heal it. Off label uses of drugs are miracles for many, so respectfully, I suggest unnecessarily alarming people into thinking their docs are intentionally harming them.
First, I'd like to say that its great that you had good outcome. I'm glad to hear that. I think in extreme cases its worth the risk of trying something novel. However, you are still left with the 2 problems pointed out in the article:
1. in the absence of any controlled trials, you can't say for certain what caused the improvment.
2. you really have no idea of what the potential adverse effects are when you give a drug to a population for which it wasn't studied.I am also puzzled about your statement that 'psychiatry is an art form'. Either its an art form, or its medicine based on sound science, with repeatabled and demonstrable results. Treating people with diabetes, heart disease, immune system dysfunction is not an art form. It's science based. As are nuclear physics, electrical engineering, anthropology, and mathematics.
So, I think the premise of the article stands, insofar as with off label precribing you can't be sure that the treatment effect is not placebo effect, and you are assuming a huge unknown risk.
As far as being less acussing of drug companies of these days, they have more congressional lobbyists
than any other industry, and more drugs have been withdrawn from the market in the last decade than have been withdrawn in previous decades. And those were drugs being used for approved indications. And there is a lot evidence out that there the drug companies knew about many of those adverse events and didn't disclose them.I guess MY point is that a lot of the off label prescribing that goes on is NOT for extreme cases like your nephew where the possible benefit outweighs the unknown risks. Docs are too cavalier about it. Its basically experimenting on patients without their consent.
Posted by JLM on January 2, 2004, at 8:52:14
In reply to Risperdal - twitching down under, posted by Utopia on January 1, 2004, at 16:55:31
> Hi
>
> For years I took Risperdal to help my sleeping. Not for schizophrenia but to assist my sleep and anxiety including panic attacks.
>
> I took a minute dose. It worked like a charm. As far as I could tell there were no side effects and I slept like a baby.
>
> Then it started, a very slight twitching in my left leg that eventually would be noticeable if I was lying down on the couch with the leg semi-bent.
>
> It had not got to the point that I couldn't walk but ...man oh man was it irritating! Went to see the pdoc, took me of it and replaced it with something else. The twitch took three months to completely dissapear, I'm lucky I suppose because once there I believe it can stay, even if off the medicines-incredible!
>
> So if you're twitching down under and you're on Risperdal, see your doctor.
I'm glad you got it straightened out. I remember when Risperidal was first marketed and the drug company propaganda was that it didn't cause EPS/TD. We were giving it to the mentally retarded residents of the state facility I worked it, specifically on the claims of no TD.Well, that didn't exactly work out too good now did it? I saw several people who were completely stable, with no TD, either develop EPS/TD or just completely freak out in general. Since most were non verbal I would suspect akathisia in the 'freak out cases'.
Posted by leopard on January 2, 2004, at 9:16:29
In reply to Re: risperdal for anxiety » JacquieJ, posted by JLM on January 2, 2004, at 8:48:14
I am taking Geodon under an "off lable" guise and it has been a miracle drug for me. I am BPII and this is the ONLY drug that has helped me. I believe the drug comapny is trying to get it approved for BP/MD as we speak...I sure hope they do... in the meantime, I try to enlighten as many BPII's on this board. The lable of "anti psychotic" scared me away from it...glad I decided to take the plunge and try it. It worked.
Posted by Tony P on January 2, 2004, at 17:30:57
In reply to Re: risperdal for anxiety » JLM, posted by leopard on January 2, 2004, at 9:16:29
A small dose of Risperdal seems to be helping me quite a lot (very recent).
I am in the process of some major changes in my meds, after a tentative rediagnosis as BP 2 or 3: mainly getting off Serzone and on to Lamictal. After the usual buildup I started experiencing extreme anxiety after 3 days at 100 mg Lamictal per day. My MD put me on 4 mg/day clonazepam as an emergency measure - helped a lot for a week, but afrter that I was simply not coping with ordinary life. After seeing my pdoc, I suggested Risperdal myself, as I was really feeling *crazy* - I couldn't think of any more technical way to put it!!
He wa perfectly willing to give it a try. He prefers Seroquel because of lower S/E profile, but he happened to have some samples of Risperdal .25, and said go ahead and try it - 1 to 4 a day.
I am currently taking .5 mg a day, and what a difference! My feelings seem to make sense, I am no longer swinging wildly or feeling euphoric from the clonazepam, I just feel generally more sensible and normal. And I experience less inclination to self-medicate with OTC etc. A little drowsy, but, i trust that will pass.
My pdoc's hope is that as I get up to higher doses of Lamictal, it will do everything I need - antidepressant, mood stabilization and help with social/GAD, so I won't need the Risperdal or Seroquel, clonazepam, or the other meds I have been taking for a while. I am a bit sceptical still, but it sure would be good to get away from mixing medical cocktails all the time!
Posted by Utopia on January 4, 2004, at 15:37:59
In reply to Re: risperdal for anxiety » JLM, posted by leopard on January 2, 2004, at 9:16:29
tell me few things about your condition e.g. besides Bipolar II was there any otherco-morbid cinditions. Agitation, anxiety, etc. have you been treated on multiple regimens and have had multiple multiple failures? Why was Geodon so succesful?
Iknow very little about the drug Geodon, please include it's generic or pharmaceurical name so that I may do a bit of research.
Thanks a ton
Posted by leopard on January 5, 2004, at 15:10:16
In reply to Geodon - JLMspeak to me oh fountain of knowledge, posted by Utopia on January 4, 2004, at 15:37:59
Your subject title has me confused. I won't try to sort it out. ;)
I have recently (as in the past couple of months) been diagnosed with BPII and even more recently begun the long and arduous journey of exploring different ways to treat this disease.
Previous to my diagnosis, I thought I was a nervous, depressed person…plain ‘ol vanilla diagnosis. For the past 10 years I have tried several SSRI’s, various RX sleep aids, most herbal and vitamin remedies, all without success. I would become a “sleeping giant” on the SSRI’s…I would sleep 10 to 18 hours p/d only to wake up as a risk taking rageaholic. I look back on the personal/business decisions I made while taking these meds and I just cringe.
I tried Wellbutrin and Effexor last year…overlapping them for a few months. I eventually dropped Wellbutrin altogether. With all the meds I took, there was a honeymoon phase, a feeling that my brain shut down and I seemed more focused and less agitated/paranoid. The much maligned Effexor seemed to be the most effective med out of the long list I had tried.
I started taking Geodon a few months ago while I was still on Effexor. I have finally phased out the Effexor and now I am taking Geodon exclusively. I could feel the effects of Geodon from the very first pill.
Geodon has pretty much cleared up my constant negative/obsessive/paranoid thoughts. I didn’t realize how bad things were until I was no longer experiencing them. I am more even keeled and less agitated/angry. I am able to listen to others without a negative record playing in my head…I don’t “read into” things and form opinions around my warped perceptions. I am a lot less defensive, I leave the house more, I feel more at ease and accepting of others…they should dump this stuff into the general water supply. 
By far, the most interesting and conclusive proof that I have indicating am better off, is to watch other people who remind me of my pre Geodon days. It lends tremendous insight into just how much damage the chemicals in our brains, when out of control, can do to us.
My life would look much different than it does today had Geodon been around 10 years ago. I can only imagine. For now I am very happy/relieved and very sad too…I wasted so much of my life and didn’t know it…all I can do is make up for it and let as many people out there know that BP is the most mis/non/under diagnosed disease we have today… it is more prevalent than previously thought.
Reading these boards is tough sometimes…I feel like I can almost sense when someone is BP…any flavor of it… and then I read the high doses of various unipolar drugs they are taking…specifically SSRIs and I feel for them… Too bad the new antipsychotics have such scary names like, “psychotic” or rather too bad there is such a stigma surrounding mental illness and the term “psychosis.”
I have no idea why Geodon isn’t discussed more frequently on this board. I try to talk about it as much as I can and hopefully help people who remind me of my previous behaviors/feelings…a place I never want to revisit.
The generic name for Geodon is Ziprasidone. I take 20 mg at lunch time every day. It must be taken with food to work properly and it has a very short shelf life…6.5 hours…and yes, I can feel it wearing off…when it does I hit the gym or go for a walk and that seems to bring down the anxiety. I could pop another pill but I want to use the minimum amount necessary and I don’t believe there is one drug that can do it all…we need to be proactive…
I also take four teaspoons of Carlson’s fish oil every day (two teaspoons in the am and another two teaspoons in the pm), a multi vitamin, I do not drink any soda of any kind anymore and I make sure to stay away from all artificial sweeteners. I try to eat organic when possible but I never drink or eat dairy that is not organic…way too many pesticides in non organic dairy…I prefer the Horizon brand but that’s me…what else…oh, caffeine, how could I forget…the only caffeine I get nowadays is from either green tea or hot cocoa. Unfortunately, cutting back caffeine has made a huge difference in my mental stability…it was hard to let it go…but the results are worth it.
In addition to the meds, I see a shrink and have successfully used EMDR to augment my psycho therapy.
Hope this helps and best to all.
tell me few things about your condition e.g. besides Bipolar II was there any otherco-morbid cinditions. Agitation, anxiety, etc. have you been treated on multiple regimens and have had multiple multiple failures? Why was Geodon so succesful?
>
> Iknow very little about the drug Geodon, please include it's generic or pharmaceurical name so that I may do a bit of research.
>
> Thanks a ton
Posted by JLM on January 6, 2004, at 4:37:58
In reply to Re: Geodon - JLMspeak to me oh fountain of knowledge, posted by leopard on January 5, 2004, at 15:10:16
> Your subject title has me confused. I won't try to sort it out. ;)
>
> I have recently (as in the past couple of months) been diagnosed with BPII and even more recently begun the long and arduous journey of exploring different ways to treat this disease.
>
> Previous to my diagnosis, I thought I was a nervous, depressed person…plain ‘ol vanilla diagnosis. For the past 10 years I have tried several SSRI’s, various RX sleep aids, most herbal and vitamin remedies, all without success. I would become a “sleeping giant” on the SSRI’s…I would sleep 10 to 18 hours p/d only to wake up as a risk taking rageaholic. I look back on the personal/business decisions I made while taking these meds and I just cringe.
>
> I tried Wellbutrin and Effexor last year…overlapping them for a few months. I eventually dropped Wellbutrin altogether. With all the meds I took, there was a honeymoon phase, a feeling that my brain shut down and I seemed more focused and less agitated/paranoid. The much maligned Effexor seemed to be the most effective med out of the long list I had tried.
>
> I started taking Geodon a few months ago while I was still on Effexor. I have finally phased out the Effexor and now I am taking Geodon exclusively. I could feel the effects of Geodon from the very first pill.
>
> Geodon has pretty much cleared up my constant negative/obsessive/paranoid thoughts. I didn’t realize how bad things were until I was no longer experiencing them. I am more even keeled and less agitated/angry. I am able to listen to others without a negative record playing in my head…I don’t “read into” things and form opinions around my warped perceptions. I am a lot less defensive, I leave the house more, I feel more at ease and accepting of others…they should dump this stuff into the general water supply. 
>
> By far, the most interesting and conclusive proof that I have indicating am better off, is to watch other people who remind me of my pre Geodon days. It lends tremendous insight into just how much damage the chemicals in our brains, when out of control, can do to us.
>
> My life would look much different than it does today had Geodon been around 10 years ago. I can only imagine. For now I am very happy/relieved and very sad too…I wasted so much of my life and didn’t know it…all I can do is make up for it and let as many people out there know that BP is the most mis/non/under diagnosed disease we have today… it is more prevalent than previously thought.
>
> Reading these boards is tough sometimes…I feel like I can almost sense when someone is BP…any flavor of it… and then I read the high doses of various unipolar drugs they are taking…specifically SSRIs and I feel for them… Too bad the new antipsychotics have such scary names like, “psychotic” or rather too bad there is such a stigma surrounding mental illness and the term “psychosis.”
>
> I have no idea why Geodon isn’t discussed more frequently on this board. I try to talk about it as much as I can and hopefully help people who remind me of my previous behaviors/feelings…a place I never want to revisit.
>
> The generic name for Geodon is Ziprasidone. I take 20 mg at lunch time every day. It must be taken with food to work properly and it has a very short shelf life…6.5 hours…and yes, I can feel it wearing off…when it does I hit the gym or go for a walk and that seems to bring down the anxiety. I could pop another pill but I want to use the minimum amount necessary and I don’t believe there is one drug that can do it all…we need to be proactive…
>
> I also take four teaspoons of Carlson’s fish oil every day (two teaspoons in the am and another two teaspoons in the pm), a multi vitamin, I do not drink any soda of any kind anymore and I make sure to stay away from all artificial sweeteners. I try to eat organic when possible but I never drink or eat dairy that is not organic…way too many pesticides in non organic dairy…I prefer the Horizon brand but that’s me…what else…oh, caffeine, how could I forget…the only caffeine I get nowadays is from either green tea or hot cocoa. Unfortunately, cutting back caffeine has made a huge difference in my mental stability…it was hard to let it go…but the results are worth it.
>
> In addition to the meds, I see a shrink and have successfully used EMDR to augment my psycho therapy.
>
> Hope this helps and best to all.
>
>
>
>
>
>
> tell me few things about your condition e.g. besides Bipolar II was there any otherco-morbid cinditions. Agitation, anxiety, etc. have you been treated on multiple regimens and have had multiple multiple failures? Why was Geodon so succesful?
> >
> > Iknow very little about the drug Geodon, please include it's generic or pharmaceurical name so that I may do a bit of research.
>
>
> >
> > Thanks a ton
>
>LAF, I can't make any sense out of the subject title either ;)
Well, it sounds like you're on the righ track. I saw a rather interesting webcast about Fish Oil from NIH, that dealt specifically with schizophrenic patients, and in that population it seemed to be VERY helpful from the data they presented. I'll try and dig up the link.
I'm curious how you found your way to Geodon, and what exactly (and I do mean exactly here) your doc said to you that persuaded you to try it.
Your post was very interesting to me personally because my psychologist does both EMDR and is a big fan of Fish Oil. That's where I first heard about it.
Welp, anyway the fountain is now dry, at least for today ;)
PS. Is the Carlsons PCB/mercury free? I recently heard that the FDA is recommending that pregnant women not eat too much Tuna during a weeks time, due to possible contamination.
Posted by leopard on January 6, 2004, at 8:44:23
In reply to Re: Geodon - JLMspeak to me oh fountain of knowle, posted by JLM on January 6, 2004, at 4:37:58
Hi to all on this thread,
There is such good evidence out there regarding the efficacy of fish oil; it seems silly not to try it... I prefer the Carlson's brand b/c it is pcb/merc free and tastes like lemon... I also throw a couple of tablespoons of organic flaxseed oil into my morning fruit smoothie too.
The subject title really is a recipe for mental wellness for me. I have struggled for 10 years and it seems as though I have finally gotten it right.
Regardless of the meds that work out for people, I cannot dismiss the crucial role the other components have played in my road to mental health. I cannot emphasize the importance of nutrition enough. I have never been a health nut...I am still far from it!!! If this junk food, carbohydrate, caffeine Queen can cut down then anyone can. Seriously.
Before I forced myself to eat right: no soda, limited caffeine, fruits and veggies, organic dairy products, no empty carbs and only the best meat (organic, grass fed, cage free...etc), I was an up and down, mood swinging night mare.
I was never big on working out...I was blessed with my mother's metabolism, so I never really had to...I am still not a gym rat...but I do walk 30 minutes p/d....any one can do this...if this is all you do, it will still help you mentally.
EMDR has sped up my psychotherapy ten fold. After all, my shrink has had to undo decades of warped perceptions and unhealthy knee jerk responses...all due to the lovely pinging of chemicals in my head.
My MD got me to take Geodon b/c he is very aware of how suspicious and resistant to change most BPIIs are...he took out the product insert so I couldn't read it...it does say it's for schizophrenia...and said it wouldn't hurt to try it...so without an RX and the product insert...I had no scary info to read...one day I was having a meltdown and decided, "what the f***k” and popped the pill. Well, it worked...insta happy, normal, even keel.
Everyone is different but I cannot say enough about this drug and the stability it has brought me.
Good luck to everyone, I will continue to post and share my progress...it's only been a couple of months on Geodon but it seems to continue to work its magic.
Posted by JLM on January 6, 2004, at 9:15:22
In reply to Geodon+Fish oil+Vits+EMDR+Gym = :), posted by leopard on January 6, 2004, at 8:44:23
Right on :)
While i"m thinking about it, where can you purchase Carlson's for a reasonable price?
Posted by leopard on January 6, 2004, at 10:10:06
In reply to Re: Geodon+Fish oil+Vits+EMDR+Gym = :) » leopard, posted by JLM on January 6, 2004, at 9:15:22
I purchase mine from www.mercola.com
Posted by Basia on January 6, 2004, at 10:57:45
In reply to Re: Geodon - JLMspeak to me oh fountain of knowle, posted by JLM on January 6, 2004, at 4:37:58
Sounds great - I am very enthused about the prospect of changing to Geodon from Sulpiride but am worried that the switch-over may make me manic/psychotic although I want to do it slowly. I am in the middle of an intense Masters programme and the stress may be too much for me but I cannot stand another week on Sulpiride. It sounds worth changing it to me but I can't help feeling anxious - this is the worst time for me to lose it!
Has anyone else had similar experiences, got any advice?Thanks a million!
Posted by leopard on January 6, 2004, at 11:12:41
In reply to Re: Geodon - JLMspeak to me oh fountain of knowle, posted by Basia on January 6, 2004, at 10:57:45
Hey Basia,
Considering your current situation (stress factor), I would probably get off the med you are currently on and try Geodon from a clean slate...just my gut feeling...
Geodon can get spikey when combined with other meds...it's such a mellow med...try it alone to reduce any potential manic shifts.
Good luck and keep us posted!!!
~Shannon
Posted by Basia on January 6, 2004, at 14:32:28
In reply to Re: Geodon - JLMspeak to me oh fountain of knowle » Basia, posted by leopard on January 6, 2004, at 11:12:41
thanks Shannon,
I am going to have a serious chat with my psych on Friday and get put on it. I think I'm going to have to stay on the Lamictal, but hopefully he'll take me off Carbamazepine too.What a cocktail!
Anyway, I'll keep you posted!
And keep us posted on your great breakthrough with Geodon. It's good to hear success stories!Take care,
Lyn
Posted by redscarlet on January 6, 2004, at 20:59:41
In reply to Geodon+Fish oil+Vits+EMDR+Gym = :), posted by leopard on January 6, 2004, at 8:44:23
Geodon worked magic for me as well. I have NEVER been as good as I was as when I was on Geodon, however I developed VERY, VERY bad akathesia from it, I was in constant movement from head to toe. It was like the volume was being turned up and up and up on my nervous system ! I even tried several drugs to treat the akathesia but with no luck, so I had to give it up. I went back on Seroquel for a while then tried Abilify which gave me akathesia too, so I'm back on the Seroquel. I long for the 'good' that Geodon did for me, nothing has been like it. I know if I could have stayed on it it would have had life changing effects for me.
Posted by leopard on January 7, 2004, at 10:55:33
In reply to Geodon was AWESOME...for awhile...ro, posted by redscarlet on January 6, 2004, at 20:59:41
What a relief to know someone else on this board has actually taken this stuff and can relate to how great I feel. I am so bummed for you that the jitters got in the way of continuing with this miracle pill. I was on Effexor when I began Geodon and I stopped the Effexor fairly shortly thereafter...it was obvious to me that it wasn't a good combo. While I was coming off the Effexor, I was slightly jumpy or juiced inside...this did quiet down the longer I was off of it. My opinion...is that Geodon is happy by itself...I wouldn't mix a whole buncha stuff with it...just a feeling I have...not sure there is science out there to confirm what my gut is feeling but you never know...anyone know if Geodon is best taken solo? The only thing I can think of is to be totally med free and try again...ya' never know. I will keep posting as to my progress with this med...good luck everyone...and keep posting!
Posted by leopard on January 7, 2004, at 11:03:43
In reply to Re: Geodon - JLMspeak to me oh fountain of knowle, posted by Basia on January 6, 2004, at 14:32:28
HI Lynn,
Good for you! I really hope you find the relief that I have found with this med. I found some old threads about Geodon and I'll post them for your review.
Start off at the lowest dosage and stay there! For at least two weeks...just my opinion but there's no need to rush or increase a dosage if the lowest one will work for you.
Also, if you can, try to start with as clean a brain as possible...maybe reduce your other meds for a while before taking Geodon.
my 2cents :)
Posted by leopard on January 7, 2004, at 11:08:52
In reply to Re: Geodon - JLMspeak to me oh fountain of knowle, posted by Basia on January 6, 2004, at 14:32:28
Re: Geodon/Ziprasidone Users-Please Advise! » Jeff
Posted by Sunnely on April 18, 2001, at 19:59:14In reply to Geodon/Ziprasidone Users-Please Advise!, posted by Jeff on April 18, 2001, at 16:01:25
Hi Jeff,
Ziprasidone (Geodon) is a combined 5-HT2 (serotonin receptor type2) & D2 (dopamine receptor type 2) blocker. This specific chemical structure makes it an effective antipsychotic with minimal side effects (movement disorder), hence an "atypical" antipsychotic.
Ziprasidone has a potential to be an effective antidepressant because of its structural make up. It is an agonist (enhancer) of 5-HT1A (ala buspirone or BuSpar) and a blocker of the serotonin receptor type 1D (5-HT1D). It is also a moderate reuptake inhibitor of serotonin and norepinephrine (similar to some of the tricyclic antidepressants and Effexor). With its 5-HT2 antagonism (like Zyprexa, Risperdal), it may have potential as an "augmenter" to an antidepressant in the treatment of depression. All these receptor affinities makes ziprasidone, theoretically, a potential antidepressant. As a 5-HT1A-enhancer, it may confer anti-anxiety effect (like BuSpar). On the other hand, theoretically, it may also increase the risk of manic switch or rapid cycling in patients with bipolar disorder.
One of the country's noted psychopharmacologists (Peter J. Weiden, MD) own experience prescribing ziprasidone, insomnia is the most common and problematic side effect, at least when switching outpatients from other antipsychotics to ziprasidone. Often patients can't get to sleep or they do not sleep soundly. They become more alert during the day and need fewer total hours of sleep. Among his patients, insomnia seemed to occur about 50% of the time in outpatients who were switched to a starting dose. It usually happens soon after the switch - within a few days to the first week.
He described insomnia as can be quite distressing and seems to increase the overall anxiety level in some patients. He recommended some techniques to manage insomnia from ziprasidone switchover or start:
1. Evaluate for other causes of insomnia, especially caffeine intake. Some cases of ziprasidone-induced insomnia seem to improve once caffeine intake is reduced.
2. Add a benzodiazepine (e.g., lorazepam) for sleep. Patients may need higher doses of lorazepam (e.g., 2-3 mg at bedtime) for the first few weeks. His experience with insomnia from ziprasidone is that it abates in about 3-4 weeks on its own, and the lorazepam can then be tapered and discontinued.
3. Continue to overlap the older antipsychotic for a longer period of time, especially if the prior antipsychotic has a sedative effect for the patient.
4. Give more ziprasidone in the morning and less in the evening. For example, if the daily ziprasidone dose is 80 mg/day, the patient can take 60 mg capsule in the morning and a 20 mg capsule in the evening rather than 40 mg twice a day.
5. Postpone increasing the ziprasidone dose until insomnia resolves.
Dr. Weiden also mentioned that among his own cases, initial nausea occurred in about 20% of outpatients when they were first switched to ziprasidone. He states that nausea tends to occur during the first 2 weeks of treatment and then to subside on its own. The nausea appears to be sensitive to dosing adjustments and responds to a lowering of the dose or giving the ziprasidone with meals. He claims that he had never had to discontinue ziprasidone for this reason, although in several patients the dose had to be lowered.
There is not enough experience to give an exact determination as to ziprasidone's ability to cause tardive dyskinesia (TD). However, like the other atypical antipsychotics, it is expected that the risk of TD from ziprasidone is much lower than the older antipsychotics.
One of ziprasidone's main selling points is its affect on weight. It is described as being "weight neutral." Compared to the other atypical antipsychotics, ziprasidone causes the least weight gain. Ironically, ziprasidone is also a potent blocker of serotonin receptor type 2C (5-HT2C). One of the postulated causes of antipsychotic-induced weight gain is their ability to block 5-HT2C (e.g., Clozaril and Zyprexa). This proves that this hypothesis alone is not enough to explain weight gain from antipsychotics and it is most probably due to a number of mechanisms.
Ziprasidone must be taken with food. Food doubles its absorption and reaches a "bioavailability" of 60%. "Bioavailability" is the amount of drug left to enter the blood circulaltion after it passes through the liver ("first pass"). My understanding is that, if you can tolerate it, a glass of milk with ziprasidone is OK, too.
+++++++++++++++++++++++++++++++++++++> I suffer from depression and a debilitating case of GAD. I have a sister that has recently gotten off Zyprexa, but it alleviated her anxiety symptoms considerabley when she had an episode of major, major depression. For those of you that use Geodon how does it affect your anxiety and what if any problems have you had with it. I am terrified of TD, but think this could bea good fit. All advice would be appreciated. Thanks, Jeff P.S. I currently take 3000mg neurontin, 5 mg valium, and 50 mg luvox
Posted by leopard on January 7, 2004, at 11:10:27
In reply to Re: Geodon - JLMspeak to me oh fountain of knowle, posted by Basia on January 6, 2004, at 14:32:28
Re: ziprasidone- Chris
Posted by Sunnely on July 29, 2000, at 23:02:24In reply to Re: ziprasidone- Chris, posted by SLS on July 29, 2000, at 14:04:01
> According to Pfizer, ziprasidone is metabolized primarily by the CYP 3A4 enzyme, but it is not expected to produce major interactions with other drugs.
Indeed, ziprasidone is predominantly metabolized by CYP3A4. It is therefore a "substrate" of this liver enzyme. You can therefore expect that the product information will include the following warning regarding drug-drug interactions with ziprasidone:
Drugs that either moderately or markedly inhibit the action of CYP3A4, slowing down the metabolism of ziprasidone consequently raising its blood levels (with potential for prolongation of QTc on ECG) are:
1. cimetidine (Tagamet); 2. Erythromycin; 3. troleandomycin (Tao); 4. the antifungals such as ketoconazole (Nizoral), itraconazole (Sporanox); 5. antidepressants such as Prozac and Luvox; 6. diltiazem (Cardizem), a calcium-channel blocker; 7. propoxyphene (Darvon); 8. amiodarone (Cordarone); 9. some of the drugs for HIV called protease inhibitors such as ritonavir (Norvir) and saquinavir (Fortovase, Invirase); and 10. grapefruit juice.
Drugs that are known to stimulate or induce the action of CYP3A4, hastening the metabolism of ziprasidone leading to decrease in its blood levels, and consequently losing its effectiveness are:
1. carbamazepine (Tegretol); 2. phenytoin (Dilantin); 3. phenobarbital; 4. primidone (Mysoline); 5. anti-TB drug, rifampin (Rifadin); 6. dexamethasone.
Ziprasidone itself has not been found, in in vitro studies, to either induce or inhibit the cytochrome enzymes.
A couple of advantages of ziprasidone over the other atypical antipsychotics are: 1. low propensity to cause weight gain, and 2. may have antidepressant and antianxiety effect due to its moderate inhibition of both norepinephrine and serotonin reuptake.
Go forward in thread:
Psycho-Babble Medication | Extras | FAQ
Dr. Bob is Robert Hsiung, MD,
[email protected]
Script revised: February 4, 2008
URL: http://www.dr-bob.org/cgi-bin/pb/mget.pl
Copyright 2006-17 Robert Hsiung.
Owned and operated by Dr. Bob LLC and not the University of Chicago.